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BMC Cancer
Published in: BMC Cancer 1/2015

Open Access 01-12-2015 | Research article

Management of brain metastasis with magnetic resonance imaging and stereotactic irradiation attenuated benefits of prophylactic cranial irradiation in patients with limited-stage small cell lung cancer

Authors: Yuichi Ozawa, Minako Omae, Masato Fujii, Takashi Matsui, Masato Kato, Shinya Sagisaka, Kazuhiro Asada, Masato Karayama, Toshihiro Shirai, Kazumasa Yasuda, Yutaro Nakamura, Naoki Inui, Kazunari Yamada, Koshi Yokomura, Takafumi Suda

Published in: BMC Cancer | Issue 1/2015

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Abstract

Background

Magnetic resonance imaging (MRI) enables a more sensitive detection of brain metastasis and stereotactic irradiation (SRI) efficiently controls brain metastasis. In limited-stage small cell lung cancer (LS-SCLC), prophylactic cranial irradiation (PCI) in patients with good responses to initial treatment is recommended based on the survival benefit shown in previous clinical trials. However, none of these trials evaluated PCI effects using the management of brain metastasis with MRI or SRI. This study aimed to determine the effects of MRI and SRI on the benefits of PCI in patients with LS-SCLC.

Methods

The clinical records of pathologically proven SCLC from January 2006 to June 2013 in facilities equipped with or had access to SRI in Japan were retrospectively reviewed. Patients with LS-SCLC and complete or good partial responses after initial treatment were included in the study and analyzed by the Kaplan-Meier method.

Results

Of 418 patients with SCLC, 124 met criteria and were divided into patients receiving PCI (PCI group; n = 29) and those without PCI (non-PCI groups; n = 95). At baseline, ratios of patients with stage III were significantly advantageous for the non-PCI group, although younger age and high ratios of complete response and MRI confirmed absence of brain metastasis were advantageous for the PCI group. Neither median survival times (25 vs. 34 months; p = 0.256) nor cumulative incidence of brain metastasis during 2 years (45.5 vs. 30.8 %; p = 0.313) significantly differed between the two groups. Moreover, these factors did not significantly differ among patients with stage III disease (25 vs. 26 months; p = 0.680, 42.3 vs. 52.3 %; p = 0.458, respectively).

Conclusion

PCI may be less beneficial in patients with LS-SCLC if the management with MRI and SRI is available.
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Metadata
Title
Management of brain metastasis with magnetic resonance imaging and stereotactic irradiation attenuated benefits of prophylactic cranial irradiation in patients with limited-stage small cell lung cancer
Authors
Yuichi Ozawa
Minako Omae
Masato Fujii
Takashi Matsui
Masato Kato
Shinya Sagisaka
Kazuhiro Asada
Masato Karayama
Toshihiro Shirai
Kazumasa Yasuda
Yutaro Nakamura
Naoki Inui
Kazunari Yamada
Koshi Yokomura
Takafumi Suda
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2015
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-015-1593-2

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